09-1147 (RPL)P.O. BOX 1504
78-495-CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00001147
Property Address: 81790 FIORI DEL DESERTO
APN: 764-010-011-19 -30092
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 55000
T-it!t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DR CHARLES CLENDENING
81790 FIORI DEL DESERTO
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/30/09
Contractor:
Applicant: Architect or Engineer: CALIFORNIA POOLS AS
78696 HIGHWAY 1
LA QUINTA, CA 9 5
'1 I Qnnnn (760) 771-6141 0p (!
NII/' Lic. No.: 185 2 F�U,�/O3 `
lI Ci�� �Dp9
G. f,�.si,ryCq
-------------------------------------------------------------------------- z -- -------------
SED NTRACTOA'S DECLARATION WORKER'S COMPENSAT TIO
I hereby affirm under penalty of perju that I am licen rovisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations.
Section 700 0) of Division 3 of the usiness and ssionals C de, and my License is in full force and effect. I _ 1 have and will maintain a certificate of consent to self -insure for rs'� ompensation, as provided
License Class: B C53 Lic se No.: 185102 for by Section 3700 of the Labor Code, for the performance of the k for which this permit is
OWNER -BUILDER DECLARATION
I hereby affirm under enaury thatdI am exempt from the Contractor's State
Law for thetyofpsfollowing reason (Sec. 70 31.5, ness an
Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolis , or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier ARCH INS COnance
licy Number ZAWCI9090400
_ I certify that, in �thee work for which this permit is issued, I shall not employ any
person in anyme subject to the workers' compensation laws of California,
and agree thsubject to the workers' compensation provisions of Section
3700 of thehwith comply with those provisions.
WARNING: FAILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CfiffMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD TION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such p ssation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state the a above inform ion is correct. I agree to comply with all
city and county ordinances and state laws relatin building construc n, and hereby authorize representatives
of this county to enter upo ie above -mention property for ins - ion ses.
Date: ,nature (Applicant or A nt):
Application Number . . . . . 09-00001147
Permit
BLDG POOL PERMIT
Additional desc .
Permit Fee . . . .
437.00 Plan Check
Fee
284.05
Issue Date . . . .
Valuation
. . . .
55000
Expiration Date
4/28/10
Qty Unit Charge
Per
Extension
BASE FEE
414.50
5.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
22.50
Permit
MECH POOL
Additional desc .
Permit Fee . . . .
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
0.
Expiration Date
4/28/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA MECH FURNACE >100K
11.00
Permit
ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . .
45:00 Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . . .
0
Expiration Date
4/28/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
----------------=-----------------------
EA ELEC PRIVATE SWIMMING
------------------------------
POOL
30.00
------
Permit
PLUMBING
Additional desc . .
Permit Fee . . . .
33.00 Plan Check
Fee
8.25
Issue Date . . . .
Valuation
0
Expiration Date
4/28/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
--------------------------------------------------- ------------------------
Special Notes and Comments
POOL/SPA. ALARMS/BARRIERS
SHALL BE IN
LQPERMIT
11
LQPERMIT
Application Number . . . . . 09-00001147
----------------------------------------------------------------------------
Special Notes and
Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2007
CODES.
-----------------------------------------------------------------------------
Other Fees . . .
. . . .. . . BLDG STDS ADMIN (SB1473)
3.00
Fee summary
Charged
--------------------
Paid
Credited
--------------------
Due
-----------------
Permit Fee Total
541.00
.00
.00
541.00
Plan Check Total
310.05
.00
.00
310.05
Other Fee Total
3.00
.00
.00
3.00
Grand Total
854.05 _
.00
.00
854.05
•
4
Bin #
City of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Build ing Permit Application and Tracking Sheet
Permit #
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Project Address:'S ..IC10 `
Owner's Name: C.lW
A. P. Number:
Address:
Legal Description:
City, ST, Zip: w4 061mm, cizz
Contractor: .6
telephone —
Address:
Project Description:
City, ST, Zip: 226 dZ ,
KIM
Telephone: <>
le P
State Lie. #: I 86' fn— City Lic. #; Q
Arch., Engr., Designer:
Address:
City., ST, Zip:
>`:> <'s
Telephone:::::f;::;;::«;:;:;;:<.:.:;«..<;<»»»:::<;.
State L ic. #
Name of Contact Person: V 1 !�}
Construction Type: Occupancy:
P type �'air Demo
Project a circle one • N Addn Alter Re
J P P
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Pro' "51 Q t=0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
�00�
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2". Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
'
Total Permit Fees
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